Thrombosis of the straight sinus and microbleedings due to deep seated arteriovenous fistula – Hemodynamic changes, cognitive impairment and improvement after microsurgery. A technical report. (October 2019)

• Record Type: Journal Article
• Authors: Dinc, Nazife; Won, Sae-Yeon; Eibach, Michael; Quick-Weller, Johanna; Keil, Fee; Berkefeld, Joachim; Konczalla, Jürgen; Marquardt, Gerhard; Seifert, Volker
• Is Part Of: Journal of clinical neuroscience. Volume 68(2019)
• Page Start: 317
• Page End: 321
• Publication Date: 2019-10
• Subjects: Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2019.07.012
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Presentation of hemodynamic flow conditions by an infratentorial dural fistula and its effects on the basal ganglia. Cognitive impairment and aphasia due to venous congestion and rapid improvement after treatment. Rare and interesting case. Informative presentation of hemodynamic changes after closure of dural fistula. Fast clinical improvement after closure of dural fistula. Abstract: Dural arteriovenous fistulas (dAVF) are rare vascular malformations accounting for only 10–15% that may lead to life threatening deficits due to hemodynamic changes in blood supply and pressure conditions. We present a 64-year old patient who was admitted with disorientation and aphasia. Following images confirmed an infratentorial dural fistula draining into the straight sinus. Additional findings were progressive thrombosis of the straight sinus, microbleedings and bithalamic edema due changes in hemodynamic conditions and venous congestion. Microsurgery was performed. After treatment improvement in clinical condition was observed and the venous congestion was regressive. Hemodynamic changes due to infratentorial dAVFs may lead to bleedings in deep regions and worsening of clinical condition fastly. Treatment requires carefully planning and visualization of angioarchitecture. Symptoms and hemodynamic changes are reversible after treatment, which are essential for treatment decisions.